Concussion Facts for parents
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This fact sheet is for parents of children and teens who have recently had a concussion. It will tell you what to expect over the next days and weeks and offer some suggestions for helping your child through the recovery period.

What is a concussion?
Other terms for a concussion include “head injury” and “mild traumatic brain injury.” A concussion usually is caused by a bump, blow, or jolt to the head. in most cases, children hit their heads without getting a concussion.  That is because the brain is protected by the skull which is a very hard covering made of bone that works like a helmet. But if the head is hit hard enough, the brain can be shaken around inside the skull causing a concussion. Common causes of a concussion are car or ATV crashes, falls from bikes and skateboards, and sports-related accidents.

What happens after a concussion?
After a concussion, less than 10 percent of children lose consciousness or are “knocked out” for a short time. A child can have a concussion without losing consciousness. Most children don’t feel well for a while after a concussion but recover quickly. However, every child is different and some take longer to get better than others. Common problems (symptoms) you may notice in your child after a concussion are listed below.  It is important to remember that the symptoms are a normal part of recovery and usually go away on their own. If you notice any of these symptoms, you should talk with your child’s doctor to find out whether any treatment is necessary.

Physical

  • Headaches
  • Fatigue, seeming tired, trouble staying awake
  • Trouble sleeping
  • Lack of energy, slow-moving
  • Blurry or double vision
  • Sensitivity to noise or light
  • Dizziness, feeling lightheaded
  • Nausea

Thinking (Cognitive)

  • Not remembering how the concussion happened
  • Becoming easily confused
  • Slowness in thinking, seeming “foggy” or “zoned out”
  • Difficulty paying attention
  • Forgetfulness, memory problems
  • More difficulty at school than normal

Emotional and Behavioral

  • Becoming easily annoyed or angry, seeming cranky and irritable
  • Feeling worried or nervous
  • Seeming emotional, crying more easily than normal
  • Not seeming like himself/herself, personality changes

What should I do if I think my child has had a concussion?
Seek medical attention right away. A healthcare professional experienced in concussion management can determine how serious the concussion is, if any medical treatment is needed, and when it’s safe for your child to return to school and physical activities including sports.

Be alert for symptoms that worsen.
In the first 1-2 days after the injury, you should watch your child very carefully. You should get immediate medical help if your child:

  • Loses consciousness
  • Is extremely sleepy or drowsy and can’t be awakened
  • Vomits repeatedly
  • Gets a headache that worsens, lasts for a long time, or is severe
  • Has weakness, numbness, trouble walking, or decreased coordination
  • Has difficulty recognizing familiar people
  • Is very confused
  • Has trouble talking or slurred speech
  • Has a seizure (arms or legs shake uncontrollably)
  • Cries nonstop and cannot be comforted
  • Has any other sudden or unusual change in thinking or behavior

What can I do to help my child get better?
A concussion can be scary and stressful for both you and your child. It’s important to remember that most problems will last for only a short time. As the days go by, you can expect your child to feel better gradually. It’s also important to remind yourself that all children occasionally have some of the same problems that can happen after a concussion even when they haven’t had a head injury. For example, chances are that your child sometimes was irritable, seemed more tired than usual, or sometimes forgot things even before the accident. Try to deal with these things the same way you did before. You can also help by taking an active role in your child’s recovery.

Share information. Tell your child what to expect as he gets better. Encourage your child to talk with you about any symptoms he/she is having, and to come to you with any questions or concerns. Children who are given information about their concussion and reassured that they will get better tend to recover more quickly. Sharing information about the concussion with the other important people in your child’s life is also recommended so they can understand what has happened and how to help. This includes your child’s siblings, teachers and other school staff, coaches, and babysitters.

Keep your child safe. While your child is still experiencing concussion symptoms, it will be especially important to prevent a second concussion. Children who have had more than one concussion can take more time to heal and sometimes start to have longer-term problems. For this reason, your child should take a break from sports and high-risk/ high-speed activities that might cause another head injury until she no longer has any concussion symptoms. This includes bikes, ATV’s, rollerblades, skateboards, playground equipment, roller coasters, and trampolines.

Take it slow. The brain needs time to heal after a concussion. Children should not return to activities until they are symptom free. Ignoring symptoms, trying to “tough it out”, or doing too much too soon can make problems worse. In the first days after the accident, don’t expect too much. Your child will probably need lots of “down time”. Exercise or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games may cause concussion symptoms to reappear or get worse. If your child’s symptoms come back or new symptoms occur as he becomes more active, it’s a sign that your child is pushing himself too hard. Have your child stop the activity and get some rest, and then take things a bit slower the next time.

Provide a healthy lifestyle. During the time that your child is healing, be sure to offer healthy foods and encourage your child to drink plenty of water.

Encourage rest. Many children need more sleep than usual while recovering from a concussion. An earlier bedtime may help. There should be no late nights and no sleepovers. Allowing naps during the day is okay, too.

Reduce distractions. When your child needs to pay attention, such as when doing homework or talking to you about something important, it will help to provide a quiet place in the house. For example, turn off the radio or television.

Provide memory help. Some children are forgetful after a concussion. You can help by giving directions one step at a time so there is less to remember. When there is more than one step to keep track of, help your child write things down. Your child also may need you to repeat what you have already told her and to provide extra reminders.

Allow extra time. Some children can seem slowed down after a concussion. If so, allow more time than usual for your child to answer questions and finish tasks. Make sure your child doesn’t feel pressure to get things done quickly.

Allow more breaks. Paying attention, especially during hard or boring tasks, can be difficult after a concussion. Encouraging your child to take short rest breaks when doing homework and other similar tasks will help.

Offer emotional support. Your child may feel upset, frustrated, sad, or angry because he cannot return to sports and hobbies right away, cannot keep up with schoolwork, or cannot spend as much time with friends. Talk often with your child about these feelings and give lots of encouragement. It’s important for children to know that any restrictions are meant to help them heal and are not meant to be a punishment.

Be patient. After a concussion, your child might seem cranky, irritable, short-tempered, or more emotional and easily upset. Try to be understanding when this happens. Give your child time to calm down before trying to talk through a problem or disagreement. Once your child is calm, you may want to encourage her come up with a few different ways to deal with the situation and help him/her pick the best one. If the behavior continues, talk with a doctor.

What about school?
Suggested steps to follow after your child’s concussion are listed below.

 
  • Giving your child a seat near the teacher and in a quiet place
  • Making time to check-in with your child during the school day
  • Adding rest breaks to your child’s school schedule
  • Allowing your child to go to the nurse’s office if he is not feeling well
  • Helping your child get caught up on any missed work
  • Not asking your child to make up all the missed work
  • Reducing assignments and homework
  • Allowing assignments to be turned in late
  • Allowing extra time to finish tests
  • Postponing tests
  • Keeping your child out of PE and active recess
  1. Ask your child’s doctor or nurse when it will be okay for your child to go back to school. Most children stay home for a day or two after a concussion. But children with a lot of symptoms may need more time at home and may need to return to school slowly. For example, they may start by attending a few hours, and if that goes well then increase to a half day, and then to a full day.
  2. Tell your child’s school team (teachers, guidance counselor, nurse, principal, coach) about the concussion even if it happened over the summer. Be sure to share any recommendations you have received from your child’s medical team.
  3. Have teachers and other school staff monitor your child closely for the next 1-2 months. They should look out for the common physical, thinking, behavioral and emotional problems listed earlier. Stay in close contact with teachers to share information about how your child is doing at home and school. As your child’s symptoms decrease, the extra help and support can be removed gradually.
  4. If your child is having any problems at school, talk with the child’s teachers about providing extra help right away. If problems last more than a few weeks, a formal written school plan may need to be developed. Possible help that your child’s teachers can offer includes:
  5. If problems at school last more than 2-3 weeks, your child should be checked by a healthcare professional who knows about concussion. Medical doctors and nurses should be asked about any physical problems (e.g., headaches, dizziness). a special type of evaluation called a neuropsychological assessment can be helpful when your child is having changes in thinking skills, school performance, or behavior. the goal of the evaluation is to give you, your child, and your child’s teachers specific recommendations to follow during the recovery period.

Missouri law includes the Interscholastic Youth Sports Brain Injury Prevention Act. The law says that an athlete who appears to have sustained a concussion must immediately be removed from play or practice for at least 24 hours.

The athlete must be examined by a licensed health care provider trained in the evaluation and management of concussions and must receive written clearance to return to play or practice from that provider. If your child has not already been seen by a concussion specialist, a good starting point is to contact his pediatrician for help.

As long as your child is having any symptoms caused by the concussion, it will be very important to prevent a second concussion. therefore, your child should not do any of the following until a doctor or nurse says it is okay:

 
  • Any sports
  • Riding a bike, scooter, motorcycle, atv, 4-wheeler, or horse
  • Driving a car
  • Skateboarding, rollerblading, ice-skating
  • Snow or water skiing, snowboarding, sledding
  • Martial arts
  • Gymnastics
  • Jumping on a trampoline
  • Climbing activities (for example, playground equipment, trees)
  • Roller coasters and other amusement park rides
  • Any other activity in which your child might hit or jolt her head

When can my child return to normal physical activities including sports?
Your child’s doctor or nurse will tell you when it’s safe for your child to resume physical activity and help you make a plan to return your child to those activities in a step-by-step, gradual fashion.

Even when your child is recovered from the concussion, you play an important role in helping to do everything possible to prevent another head injury. Children should always wear a seatbelt. Children should also always wear a helmet when riding a bike or ATV, rollerblading, or doing anything else that could cause a head injury. And children should always use proper safety gear when playing sports.

If you have any questions that were not answered by this fact sheet, ask your child’s doctor or nurse for more information. We hope your child feels better soon!

References
Concussion in Children and teenagers: information for Parents and other Caregivers (2006), by Michael W. Kirkwood, Phd, Pamela e. Wilson, Md., & Joseph Wathen, Md.

Facts about Concussion and Brain injury (2010). Centers for disease Control and Prevention. www.cdc.gov/Concussion.

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